Some recent articles about the controversy in Chicago with EMS responses and the availability of ambulances;

This from CBSChicago about a memo to dispatchers:

The CBS 2 Investigators and the Better Government Association have been warning about an apparent shortage of Chicago ambulances and paramedics. The result: dangerous delays for patients needing emergency care.

So far, it seems the city is trying to cover the problem up instead of fixing it. In the meantime, the response times for ambulances are just getting worse.

“Anybody available downtown that can take a run,” a dispatcher’s voice crackles through the scanner speaker.

These are the types of calls paramedics say happen every day. “It’s clear they have no ambulances and it clearly validates what we’ve been saying that they need more ambulances,” said paramedic field chief Pat Fitzmaurice.

But now, city officials apparently don’t want the media or anyone else with a scanner to hear some of those transmissions asking for help. They are asking dispatchers to watch what they say.

CBS 2 and the BGA obtained a copy of a memo written by a supervisor at the Office of Emergency Management. It called shout-outs for any available ambulances: “not an acceptable practice.”

The memo instructs dispatchers to, “Avoid terminology like we have no ALS (advanced life support) ambulances available,”….particularly when they have to send a basic life support ambulance to the scene and a fire engine with a paramedic on board. Basic life support ambulances do not have paramedics and the same equipment as advanced life ambulances.

Dispatchers should use ambulance numbers to instruct staff in the field on what to do in those cases, the memo said, adding, “Hopefully we can get the message across without highlighting the fact that no ALS unit is available.”

The memo also concedes that, “We all realize that certain times we are inundated with runs and lack of resources.”

This is from EMS1.com:

A city-issued memo obtained by CBS Chicago asks dispatchers to watch what they say, calling shout-outs for available ambulances “not an acceptable practice” and instructing dispatchers to “avoid terminology like we have no ALS ambulances available” so as not to highlight the fact. Written by a supervisor at the Office of Emergency Management, the memo also states, “We all realize that certain times we are inundated with runs and lack of resources.”

Better Government Association CEO and President Andy Shaw said the city should be addressing it.

A spokeswoman from Chicago’s Office of Emergency Management said the memo is an “informal internal document” that serves as a reminder to dispatchers to use “approved protocol and professionalism.”

CBS has continued coverage of long response times, including incidents where it took 16 minutes for an ambulance to respond to a woman struck by a postal truck while crossing the street, 22 minutes for an elderly patient complaining of chest pains, and 26 minutes for an ALS response to the home of an elderly woman having trouble breathing.

A spokesman for the Fire Department said the 26-minute response time was “unacceptable” and the incident is under investigation. In a written statement, the Fire Department said it is conducting a review of its ambulances to ensure deployment meet the needs of Chicago.

Also from EMS1.com:

The head of most EMS operations is the communication center. The responsibility is huge. It is the first point of contact for the community when reporting medical emergencies.

[Dispatchers] coordinate the system’s resources, trying to match the appropriate unit to the appropriate incident. Dispatchers use various forms of technology to help make those decisions: software, GPS, dispatch algorithms, among others. The system has to be able to send the appropriate resources at the right time to avoid going to a zero-level condition. Sometimes that’s unavoidable, but regulating the system to minimize a zero-level condition can help reduce the possibility.

How does Chicago keep track of their resources? It seems a little strange that a dispatcher doesn’t know where the units are at any given time. While Chicago is a big system, other similarly sized systems seem to be able to tell which ambulance should go where at any point in time. Is this a sign of a larger issue? If there are ways to increase the effectiveness of system operations, throwing more ambulances at the problem isn’t necessarily the fix.

Tags: ambulance response times, ambulance shortage in Chicago, Better Government Association, Chicago Fire Department, Fire Commissioner Jose Santiago, Inspector General Joseph Ferguson, National Fire Protection Association, Office of Emergency Management, Pam Zekman, Paramedic Field Chief Patrick Fitzmaurice